Emerald Coast Neck & Back Clinic, P.A.
LBN: Emerald Coast Neck & Back Clinic, P.A.
Emerald Coast Neck & Back Clinic, P.A. is an health care organization with primary practice located at 1003 College Blvd W Suite 4, Niceville FL 32578-1068. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is the primary health care specialty.
Emerald Coast Neck & Back Clinic, P.A. can be contacted via phone (850) 279-6485, or through Koulisis, Christo W. via phone (850) 279-6485.
Contact Information
Primary practice address
1003 College Blvd W Suite 4
Niceville FL 32578-1068
Phone: (850) 279-6485
Fax: (850) 279-6546
Website:
Authorized official contact:
Name: Koulisis, Christo W. Doctor of Medicine (MD)
Phone: (850) 279-6485
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | ME0053933 | Florida |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | ME0053933 | Florida |
Profile Details
| NPI number | 1386916237 |
|---|---|
| LBN Legal business name | Emerald Coast Neck & Back Clinic, P.A. |
| DBA Doing business as | |
| Authorized official | Koulisis, Christo W. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 7th, 2012 |
| Last updated | Dec 29th, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386916237 | NPPES |
| Florida | Other | 162510700 | DEPARTMENT OF LABOR |
| Florida | Other | 07915 | DEPARTMENT OF LABOR |
| Florida | MEDICAID | 256355000 | DEPARTMENT OF LABOR |
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